Krista Wenz Authored By: Krista Wenz
NREMT EMT Certification

The National Registry of Emergency Medical Technicians (NREMT) has 4 EMT certifications. Each EMT certification has various requirements and allows the person to do different things. 

Each certificate builds on the previous one, so your knowledge will continue to increase as you climb the “ladder” of EMT levels. Keep in mind that you do not need to climb the ladder of EMT certification if you do not want to, you can stay at the first level if you wish.

EMT Certification

There used to be 5 different levels of EMT certifications. In 2014, that was changed to 4. The 4 current EMT levels are:

  1. Emergency Medical Responder (EMR)
  2. Emergency Medical Technician (EMT)
  3. Advanced Emergency Medical Technician (AEMT)
  4. Paramedic

We will review each EMT certification in-depth below. Please note that each certification will require you to pass an exam. You can read our guide on the different EMT tests to see what specifically will be on those exams.

If you are looking for practice questions, consider our EMT practice tests for help.


See Our Top Recommended EMT Prep Course

  1. BoostPrep EMT Prep Course - Best for Practice Questions

EMR Certification

This is the entry-level NREMT EMT certification, which provides immediate lifesaving care to critical patients. The primary role of an emergency medical responder (EMR) is to take care of the situation while waiting for additional EMS personnel to arrive on the scene. 

Almost all police and fire agencies require their employees to be first responders, a person with specialized emergency medical training. A first responder must have the basic skills and knowledge to perform lifesaving procedures while awaiting additional support from higher-level personnel.  

Emergency medical responders provide a key role in the overall EMS system by performing basic interventions (with minimal equipment) under medical oversight.

EMR Certification Process

To apply for the Emergency Medical Responder certificate, applicants must meet the following requirements: 

  • Complete a state-approved Emergency Medical Responder course 
    • Please note that this course must have been completed within the past two years
    • The program director for the course must also verify that you have successfully completed the course on the National Registry website
  • Applicants must have a valid CPR-BLS for "Healthcare Provider" or equivalent credential
  • Completion and passing of the Emergency Medical Responder Cognitive exam along with completion of the state-approved Psychomotor examination
    • The Psychomotor exam is administered by either the state or a state-approved training institution
    • After passing each exam, they will remain valid for 24 months

EMT Certification

This is the second level of the NREMT EMT certification, providing Pre-hospital (out of hospital) emergency and transportation care. Emergency medical technicians (EMTs) are able to use the basic equipment found on an ambulance to assist patients. 

Emergency medical technicians play a critical role between the emergency scene and the health care system.

EMT Certification Process

In order to apply for the emergency medical technician certificate, applicants must meet the following requirements: 

  • Applicants must be 18 years of age or older
  • Complete a state-approved Emergency Medical Technician course 
    • Please note that this course must have been completed within the past two years
    • The program director for the course must also verify that you have successfully completed the course on the National Registry website 
  • Applicants must have a valid CPR-BLS for "Healthcare Provider" or equivalent credential
  • Completion and passing of the Emergency Medical Technician Cognitive exam along with completion of the state-approved Psychomotor examination
    • The Psychomotor exam is administered by either the state or a state-approved training institution
    • After passing each exam, they will remain valid for 24 months

You can read our complete guide on how to become an EMT for more information on this and the requirements.

AEMT Certification

This is the third level of the NREMT EMT certification. An advanced emergency medical technician also provides pre-hospital emergency and transportation care. 

An advanced emergency medical technician can provide limited advanced medical care. This would be the next step for an emergency medical technician who would like to make more money or become a paramedic.

AEMT Certification Process

To apply for the advanced emergency medical technician certificate, applicants must meet the following requirements: 

  • Applicants must be 18 years of age or older
  • Must have an NREMT or state license at the EMT level (or higher)
  • Complete a state-approved Advanced Emergency Medical Technician course 
    • Please note that this course must have been completed within the past two years
  • Applicants must have a valid CPR-BLS for "Healthcare Provider" or equivalent credential
  • Completion and passing of the Advanced Emergency Medical Technician Cognitive exam along with completion of the state-approved Psychomotor examination
    • The Psychomotor exam is administered by either the state or a state-approved training institution
    • After passing each exam, they will remain valid for 24 months

Paramedic Certification

This is the final level of the NREMT EMT certification. A paramedic has the primary goal of providing advanced emergency medical care to patients. A paramedic has the knowledge and skills to provide patient care and transportation to the appropriate medical facility. 

Paramedics can administer a wide range of medications, provide advanced life support, and perform advanced surgical and electrical therapies.

Paramedic Certification Process

To apply for the paramedic certificate, applicants must meet the following requirements: 

  • Applicants must be 18 years of age or older
  • Must have an NREMT or state license at the EMT level (or higher)
  • Complete a CAAHEP-accredited paramedic program 
    • Please note that this course must have been completed within the past two years
    • The program director for the course must also verify that you have successfully completed the course on the National Registry website
  • Complete a Psychomotor competency portfolio
  • Applicants must have a valid CPR-BLS for "Healthcare Provider" or equivalent credential
  • Completion and passing of the paramedic Cognitive exam along with completion of the state-approved Psychomotor examination
    • The Psychomotor exam is administered by either the state or a state-approved training institution
    • After passing each exam, they will remain valid for 24 months

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