Amends GS 131E-155 by amending the definition of the practical examination that individuals seeking credential as an emergency medical technician, advanced emergency medical technician, paramedic, emergency medical responder, emergency medical dispatcher, or emergency medical services instructor to require the test comply with National Registry of Emergency Medical Technicians exam standards.

Amends the credentialing requirements for those individuals, found in GS 131E-159, by adding the following requirements. Beginning January 1, 2026, a person seeking credentialing or renewal of credentialing emergency medical responders, emergency medical technicians, advanced emergency medical technicians, paramedics, emergency medical dispatchers, and emergency medical services instructors must pass the National Registry of Emergency Medical Technicians examination for the level of certification desired. Requires a person with a state credential or other accepted credential not from the National Registry of Emergency Medical Technicians for their respective certification before January 1, 2026, to be certified under the National Registry of Emergency Medical Technicians by January 1, 2030. Also requires those individuals to undergo a criminal history records check.

Limits how long an individual currently credentialed as an emergency medical dispatcher who is currently residing in North Carolina or affiliated with an emergency medical dispatcher program approved by the Department of Health and Human Services offering service within North Carolina is eligible for credentialing as an emergency medical dispatcher without taking an exam to one year. Adds that if a person seeking credentialing holds a state-level certificate as an emergency medical technician, advanced emergency medical technician, paramedic, emergency medical responder, emergency medical dispatcher, or emergency medical services instructor in another state, the person must obtain a credential from the National Registry of Emergency Medical Technicians within one year of the issuance of their credentialing in this state; after one year requires passage of the exam to continue to be credentialed.

Requires any person seeking credentialing as a specialty certification, including a flight paramedic, critical care paramedic, community paramedic, tactical paramedic, wilderness paramedic, designated infection control officer, or a medical transportation safety professional, to pass the appropriate exam from the International Board of Specialty Certification.

Requires credentialed persons to carry a certification card. Provides for obtaining replacement cards.

Requires the Medical Care Commission to adopt temporary rules to implement this act, which will remain in place until permanent rules are adopted.

Effective January 1, 2026.